Short-term outcomes of gastrectomy after neoadjuvant chemotherapy for clinical stage III gastric cancer: propensity scor
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ORIGINAL ARTICLE
Short‑term outcomes of gastrectomy after neoadjuvant chemotherapy for clinical stage III gastric cancer: propensity score‑matched analysis of a multi‑institutional database Shinichi Umeda1 · Mitsuro Kanda1 · Koki Nakanishi1 · Seiji Ito2 · Yoshinari Mochizuki3 · Hitoshi Teramoto4 · Kiyoshi Ishigure5 · Toshifumi Murai6 · Takahiro Asada7 · Akiharu Ishiyama8 · Hidenobu Matsushita9 · Dai Shimizu1 · Daisuke Kobayashi3 · Chie Tanaka1 · Michitaka Fujiwara1 · Kenta Murotani10 · Yasuhiro Kodera1 Received: 31 July 2020 / Accepted: 12 September 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purpose Preoperative chemotherapy for gastric cancer may be effective from the standpoint of compliance, although there is insufficient evidence of its efficacy. We analyzed a multicenter database to clarify whether preoperative chemotherapy influenced the short-term outcomes of gastrectomy. Methods We analyzed, retrospectively, 3571 patients who underwent gastrectomy between January, 2010 and December, 2014. Patients with clinical stage-III gastric adenocarcinoma were divided into a neoadjuvant chemotherapy (NAC) group and a non-NAC group. We performed propensity-matched comparative analysis to stratify the groups according to age, sex, tumor region, tumor type, preoperative stage, procedure, lymph node dissection, and tumor differentiation. Preoperative blood data, surgical findings, and postoperative complications were analyzed. Results Analysis of the matched NAC (n = 64) and non-NAC (n = 128) groups revealed that the preoperative values of neutrophils, platelets, and Hb were significantly lower in the NAC group. Blood loss during surgery was significantly higher, surgical times were longer, and the rate of repeat surgery was significantly lower in the NAC group; however, the rates of rehospitalization did not differ between the groups and mortality was 0% in both groups. Postoperative complications were not significantly different between the groups. Conclusions NAC did not increase the complication rate of gastrectomy for gastric cancer. Keywords Gastric cancer · Neoadjuvant chemotherapy · Short-term outcome · Complication
* Mitsuro Kanda m‑[email protected]‑u.ac.jp 1
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Department of Surgery, Konan Kosei Hospital, Konan, Japan
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Department of Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan
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Department of Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Japan Department of Surgery, Okazaki City Hospital, Okazaki, Japan
Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, 65Tsurumai‑cho, Showa‑ku, Nagoya, Japan
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Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan
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Department of Surgery, Komaki City Hospital, Komaki, Japan
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Department of Surgery, Tosei General Hospital, Seto, Japan
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Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume, Japan
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Department of Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan
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Vol.:(0123456789)
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